scholarly journals Estimating the levels and trends of family planning indicators in 436 sub-national areas across 26 countries in sub-Saharan Africa

2021 ◽  
Author(s):  
Joshua L Proctor ◽  
Laina D. Mercer
Keyword(s):  
Family Planning ◽  
Universal Access ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Model Based ◽  
Administrative Unit ◽  
Sub Saharan ◽  
Demographic Subgroup ◽  
Demographic Subgroups

Background: Scaling up access to safe, effective, and voluntary family planning (FP) services to achieve universal access for women and families will require increased commitment by countries and international organizations. On the way toward universal access, quantitative family planning goals have also been established by the United Nations through the sustainable development goals (SDGs). Here, we present a model-based framework that can help monitor progress toward these goals at the sub-national and demographic subgroup scale. Methods: We utilize 90 demographic health surveys for 26 countries that contain associated geographic position system data. We extract survey cluster level data to fit multiple small area estimation models that estimate FP indicators by administrative unit one and two regions as well as different demographic subgroups. Findings: We find significant variation of modern contraceptive prevalence rates (mCPR), unmet need, and demand satisfied by country, sub-national region, and demographic subgroup. Our model-based estimates show that on average for 436 administrative unit one regions, mCPR has increased at a rate of 0.75% per year and unmet need has decreased by 0.26% per year. There are also striking differences of FP indicators by demographic subgroup; for example, unmet need can be up to 40% different based on age and parity. Interpretation: We have developed a framework to help monitor progress, provide insights about the inequitable progress by region and demographic groups, and account for the sparsity of available data. These results and framework can help policy-makers better allocate and target interventions to help achieve family planning goals.

scholarly journals The unmet needs for modern family planning methods among postpartum women in Sub-Saharan Africa: a systematic review of the literature

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jumaine Gahungu ◽  
Mariam Vahdaninia ◽  
Pramod R. Regmi
Keyword(s):  
Systematic Review ◽  
Family Planning ◽  
Unmet Needs ◽  
Unmet Need ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Factors Affecting ◽  
Sub Saharan

Abstract Background Sub-Saharan Africa has the highest fertility rate in the world, with the highest unmet need for family planning (FP). Yet, there is a lack of knowledge about the determinants for non-utilisation of modern contraceptive methods among women of reproductive age. This systematic review of literature assessed factors affecting the unmet need and reasons for non-utilisation of modern contraceptive methods during the postpartum period in Sub-Saharan African women. Methods An online literature search was conducted in several databases: MEDLINE, Cochrane Review, PubMed, Elsevier's Science Direct and Web of Science. The search was completed by hand searching. Data were extracted and summarised using the Arksey and O’Malley methodology. Results In total, 19 studies were included; one qualitative study, seventeen quantitative, and one used a mixed-methods approach. Studies were conducted in Ethiopia (n = 11), Nigeria (n = 3), Kenya (n = 2), Malawi (n = 2) and Uganda (n = 1). Factors affecting the unmet need for modern contraceptive methods were described at three levels: (a) individual; (b) household; and (c) healthcare facility level. Reasons for non-use of FP included: fear of side effects; husband’s disapproval; the absence of menses; abstinence; and low perception of risk of pregnancy. Conclusion Unmet needs in postpartum FP in women from Sub-Saharan Africa were associated with health-system and socio-demographic determinants. We suggest that there is a need to improve the awareness of modern contraceptive methods through effective interventions. Further research is needed for under-studied countries in this continent.

scholarly journals Determine the unmet need for family planning in a hilly area in a state of North India

2021 ◽  
Vol 10 (6) ◽  
pp. 2234
Author(s):  
Nidhi Chauhan ◽  
Saurabh Rattan
Keyword(s):  
Family Planning ◽  
Prevalence Rate ◽  
Universal Access ◽  
Unmet Need ◽  
Reproductive Age ◽  
North India ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Contraceptive Prevalence Rate ◽  
Contraceptive Prevalence

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved, unmet need being one of the  imperative component.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to June 2019. Total sample size calculated was 316. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group (15-49 years). Male condom (36%), followed by female sterilisation (30%) were the most common methods preferred. Unmet need of family planning was found to be 10.4%.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.

scholarly journals The National Composite Index for Family Planning (NCIFP): Results and Methodological Issues

2022 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Rebecca Rosenberg ◽  
John Ross ◽  
Karen Hardee ◽  
Imelda Zosa-Feranil
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Composite Index ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Global Partnership ◽  
Planning Effort ◽  
Sub Saharan ◽  
Family Planning Effort

Background:  The “ FP2020 Global Partnership” signaled a shift to broader, rights-based approaches to family planning programs, and the National Composite Index for Family Planning was developed as part of related measurement efforts. Methods: In each country 10-15 experts on the family planning program completed a 35-item questionnaire, first in 2014 in 89 countries, and in 2017 in 84 countries. Data were entered in Excel, with checks for consistency and data quality. The total score, and scores for each of 5 dimensions of effort are averages across the 35 indicators. Analytic techniques included cross-tabulations, graphical and correlation approaches. Results: The average total score for all countries in 2017 was 64 of the maximum of 100 of effort. Sub-regions differed: Anglophone and Francophone sub-Saharan Africa (SSA) scored highest in the total score and across all 5 dimensions. Next in order came Latin America and the Caribbean, Asia, the Middle East and North Africa, and Eastern Europe and Central Asia. Despite large differences in scores, the sub-regions followed similar profiles across the 35  indicators. The long term rise in the basic family planning effort scores continued, extending the series from surveys approximately every five years beginning in the 1980s. The highest score reached was for the strategy dimension, but the others were close. Their relative levels remained essentially the same as in the 2014 survey.                     NCIFP scores correlated positively with modern contraceptive use in both the sub-Saharan Africa (SSA) and non-sub-Saharan Africa (non-SSA) countries, but the relationships were stronger for SSA. Access to long-acting and permanent methods (LAPMs) was accompanied by greater LAPM use and modern method use. Conclusion: Repeated surveys in most developing countries show improvements in family planning effort, though unevenly, by 35 indicators and across regions.

scholarly journals Currently married women with an unmet need for contraception in Eritrea: Profile and determinants

2011 ◽  
Vol 38 (1-2) ◽  
pp. 61 ◽  
Author(s):  
Gebremariam Woldemicael ◽  
Roderic Beaujot
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Economic Status ◽  
Unmet Need ◽  
Married Women ◽  
Sub Saharan Africa ◽  
The Status ◽  
Sub Saharan ◽  
Using Data ◽  
Unmet Need For Contraception

Eritrea’s contraceptive prevalence rate is one of the lowest in sub-Saharan Africa and its fertility has only started to decline. Using data from the 2002 Eritrea Demographic and Health Survey (EDHS), this study examines the determinants of unmet need for family planning that is the discrepancy between fertility goals and actual contraceptive use. More than one-quarter of currently married women are estimated to have an unmet need, and this has remained unchanged since 1995. The most important reason for unmet need is lack of knowledge of methods or of a source of supply. Currently married women with higher parity, and low autonomy, low or medium household economic status, and who know no method of contraception or source of supply are identified as the most likely to have an unmet need. Addressing the unmet need for family planning entails not merely greater knowledge of or access to contraceptive services, but also the enhancement of the status of women.

scholarly journals Unmet Need For Family Planning Among Married Women In Sub-Sahara Africa: A Meta-Analysis of DHS Data (1995 – 2020)

2021 ◽  
Author(s):  
Million Phiri ◽  
Clifford Odimegwu ◽  
Chester Kalinda
Keyword(s):  
Family Planning ◽  
Unmet Needs ◽  
Unmet Need ◽  
Central Africa ◽  
Married Women ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Sub Saharan

Abstract Background: Closing the gap of unmet needs for family planning (FP) in sub-Saharan Africa remains critical in improving maternal and child health outcomes. Determining the prevalence of unmet needs for family planning among married women in the reproductive age is vital for designing effective sexual reproductive health interventions and programmes. Here, we use nationally representative data drawn from sub-Saharan countries to estimate and examine heterogeneity of unmet needs for family planning among currently married women of reproductive age. Methods: This study used secondary data from Demographic and Health Surveys (DHS) conducted between January 1, 1995 to December 31, 2020 from 37 countries in sub-Saharan African. An Inverse Heterogeneity model (IVhet) in MetaXL application was used to estimate country and sub-regional level pooled estimates and confidence intervals of unmet needs for FP in SSA. Results: The overall prevalence of unmet need for family planning among married women of reproductive age in the sub-region for the period under study was 22.9% (95% CI: 20.9–25.0). The prevalence varied across countries from 10% (95% CI: 10–11%) in Zimbabwe to 38% (95% CI: 35–40) and 38 (95% CI: 37–39) (I2 = 99.8% and p-value < 0.0001) in Sao Tome and Principe and Angola, respectively. Unmet needs due to limiting ranged from 6%; (95% CI: 3–9) in Central Africa to 9%; (95% CI: 8–11) in East Africa. On the other hand, the prevalence of unmet needs due to spacing was highest in Central Africa (Prev: 18; 95% CI: 16–21) and lowest in Southern Africa (Prev: 12%; 95% CI: 8–16). Our study indicates that there was no publication bias because the Luis Furuya-Kanamori index (0.79) was within the symmetry range of -1 and +1. Conclusion: The prevalence of unmet need for FP remains high in sub-Saharan Africa suggesting the need for health policymakers to consider re-evaluating the current SRH policies and programmes with the view of redesigning the present successful strategies to address the problem.

scholarly journals Improving Utilisation and awareness of Family Planning services in Adults of Reproductive age through Community Sensitization in Police Wing Village, Jinja District.

2021 ◽  
Author(s):  
◽  
Rodgers Isiko
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Project Implementation ◽  
Number Of Children ◽  
Planning Methods ◽  
Sub Saharan ◽  
Family Planning Methods

Background Family planning refers to a conscious effort by a couple to space the number of children they have through the use of contraceptive methods. According to WHO, an estimated 225 million women in developing countries, 24.2% of women of reproductive age have an unmet need for contraception. However, contraceptive use in sub-Saharan Africa is low at only 21%. The total fertility rate remains high for many countries in the region (4.6 in Kenya and Rwanda, 5.4 in Tanzania, 6.2 in Uganda, and 6.4 for Burundi). Methodology This was a community-based project implementation on increasing awareness and utilization of family planning methods in Police Wing village, Jinja district. Consent was gotten from the VHT, LC1, and DHO before mobilizing people to gather at the VHT’s home and her neighbour’s compound where we carried out the different educational sessions. Different team members got different roles to play as regards the health education session. One week later, we evaluated the progress of our project implementation through the administration of questionnaires to the same people we health educated. The questionnaire assessed the level of utilization, awareness, myths, misconception, and demography of the participants. Results 28% had heard about at least three family planning methods and 24.1% had at one time used family planning while 75.9% of the participants admitted not to have used it. The post-session assessment showed an increase from 28% to 93% in knowledge regarding the available methods of FP and an increase in the utilization of FP from 28% to 42%.   Conclusion and recommendations Addressing the myths and misconceptions about FP by exposing them as a fallacy would help increase the uptake as evidenced by the will of the community to take up the different methods. Organize frequent health talks about FP in the community.

scholarly journals As long as (I think) my husband agrees…: role of perceived partner approval in contraceptive use among couples living in military camps in Kinshasa, DRC

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Julie H. Hernandez ◽  
Saleh Babazadeh ◽  
Philip A. Anglewicz ◽  
Pierre Z. Akilimali
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Educational Achievement ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Common Error ◽  
Couple Communication ◽  
Female Partners ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background Male partner’s approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men’s support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women’s perception of their partner’s opinion. Methods This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners (n = 252 couples) to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions. Results Results confirm women are poorly aware of their partner’s opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner’s actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner’s approval. Conclusions Women’s perceptions of partner’s approval are much stronger determinant of contraceptive use than the latter’s actual opinion, and stereotyping men’s opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women’s capacity to negotiate contraceptive use.

scholarly journals Determinants of unmet need for family planning in Gambia & Mozambique: implications for women’s health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Dina Idriss-Wheeler ◽  
Olalekan A. Uthman ◽  
Ghose Bishwajit
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sample Population ◽  
Inverse Association ◽  
Low Middle Income Countries ◽  
Sub Saharan ◽  
Female Headed Households

Abstract Background In low-middle-income countries, unmet need for family planning (FP) constitutes a major challenge for prevention of unintended pregnancies and associated health and psychological morbidities for women. The factors associated with unmet need for family planning have been studied for several countries in sub-Saharan Africa, but not much is known about the situation in Gambia and Mozambique. The purpose of this study was to perform a comparative analysis of the prevalence of unmet need for FP, and its sociodemographic correlates in Gambia and Mozambique to better inform FP policies and programs aimed at reducing associated negative health outcomes for women and their families. Methods In this analysis we used nationally representative data from Demographic and Health Surveys in Gambia (2013) and Mozambique (2011). Sample population were 23,978 women (n = 10,037 for Gambia and 13,745 for Mozambique) aged 15–49 years. Women who want to stop or delay childbearing but were not using any contraceptive method were considered to have unmet need for FP. Association between unmet need for FP and the explanatory variables was measured using binary logistic regression models Results Prevalence of unmet need for FP was 17.86% and 20.79% for Gambia and Mozambique, respectively. Having employment in professional/technical/managerial position showed an inverse association with unmet need both in Gambia [OR = 0.843, 95% CI 0.730, 0.974] and Mozambique [OR = 0.886, 95% CI 0.786, 0.999]. Education and household wealth level did not show any significant association with unmet need. The only positive association was observed for rural [OR = 1.213, 95% CI 1.022, 1.441] women in the richer households in Gambia. Having access to electronic media [OR = 0.698, 95% CI 0.582, 0.835] showed a negative effect on having unmet need in Mozambique. Women from female headed households in Gambia [OR = 0.780, 95% CI 0.617, 0.986] and Mozambique [OR = 0.865, 95% CI 0.768, 0.973] had lower odds of unmet need for FP. Conclusion The situation of unmet need for FP in Gambia and Mozambique was better than the Sub-Saharan African average (25%). Nonetheless, there is room for improvement in both countries. Significant assocations with lower unmet need for family planning and women’s occupational status (more education & higher skilled employment), access to mass media communication, and female-headed households provide possible areas for intervention for improved FP opportunities in the region.

scholarly journals As Long as (I Think) My Husband Agrees…: Role of Perceived Partner Approval in Contraceptive Use Among Military Couples Living in Kinshasa, DRC

2021 ◽  
Author(s):  
Julie H. Hernandez ◽  
Saleh Babazadeh ◽  
Philip Anglewicz ◽  
Pierre Z Akilimali
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Educational Achievement ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Common Error ◽  
Couple Communication ◽  
Female Partners ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: Male partner’s approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men’s support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women’s perception of their partner’s opinion.Methods: This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions. Results: Results confirm women are poorly aware of their partner’s opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner’s actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner’s approval. Conclusions: Women’s perceptions of partner’s approval are much stronger determinant of contraceptive use than the latter’s actual opinion, and stereotyping men’s opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women’s capacity to negotiate contraceptive use.

scholarly journals The relationship between spatial access and modern contraceptive use: is proximity to a healthcare facility a determinant of use among women in Kinshasa, DRC?

2021 ◽  
Vol 5 ◽  
pp. 80
Author(s):  
Saleh Babazadeh ◽  
Julie Hearnandez ◽  
Philip Anglewicz ◽  
Jane Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Background: Spatial access has a direct effect on health service utilization in many settings. Distance to health facility has proven to affect family planning (FP) service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay. This study analyzed the significance of proximity to family planning services, service availability, and quality of family planning services on modern contraceptive use in Kinshasa, Democratic Republic of the Congo. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa from PMA2020 between 2014 and 2016. We used GPS coordinates to calculate the distance between the health facilities and households. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: 10,968 women were interviewed over four rounds of data collection. Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are strong barriers for women in Kinshasa to use modern contraceptives. Proximity to quality services did not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusions: This study notes that barriers other than proximity to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

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